In recent years Orthodontists/dentists with a passion for optimizing facial growth/airway health have recognized the importance of tongue tie as a barrier to ideal facial growth/airway health. John Mew has shown that optimal rest oral posture with teeth lightly together, the tongue firmly to the palate, and lips together without strain is the way to have optimal facial development/airway health. A tongue tie is a very common barrier to a child getting and keeping the tongue to the palate. Many people in industrialized societies have recessed upper and lower jaws due to an unrecognized or untreated neonatal tongue tie.         

Depending on the exact definition of when a tongue is tied the incidence may vary as much as from 2-20%.   This large variance among various studies probably reflects the fact that there is a large variance in the degree of tongue tie, as well as the overall definition of what constitutes a tongue tie. Let us just simplify things and state that anything which prevents a child from getting and keeping the tongue up on the palate at rest can be a problem which may dramatically alter a patient’s genetic plan for ideal facial growth. In turn, lack of proper forward facial growth according to our genetic plan can result in both jaws being recessed resulting in the airway behind the soft palate and the tongue being reduced. OSA is the ultimate result of reduced airways and untreated OSA can reduce  lifespan by 20%. OSA is becoming the most common chronic disease in industrialized countries and is correlated with most, if not all, chronic diseases known to man.

Tongue tie has been historically understood for centuries by midwives delivering babies and seeing a neonate unable to breastfeed. Midwives would solve the problem by freeing the tongue with their sharp fingernails. This may seem barbaric, but ankyloglossia (tongue tie) has more recently come to the attention of forward thinking pediatricians, pediatric dentists, orthodontists, general dentists doing orthodontics in addition to myofunctional therapists, lactation consultants, physical therapists, and other health care related professionals. Mammals were meant to breastfeed, and proper facial development depends on breastfeeding for a far more extended period of time than is usual in modern societies. Children’s faces have fallen back as a result.    

There are a number of reasons speculated by the medical/dental profession for what seems like a dramatic increase in occurrence of infant tongue tie and neonatal tongue tie. I’m not here to identify a cause, but to raise awareness of the problem and call for the problem to be resolved at the earliest possible age so that proper breastfeeding can occur which will result in better facial balance and more optimized airways.

Many of us in the dental profession recognize an additional problem with tongue tie in adults.  Clenching and/or grinding patterns with serious, often life altering pain patterns, may also be caused or intensified in tongue tied individuals. I have witnessed complete and total resolution of clenching and grinding when a release is done.   I learned nothing about this in my formal dental/orthodontic training. Don’t expect most health care providers to understand this connection.

As with many things in medicine and in our society in general, there is much controversy. Finding a consensus on much of anything in health care will take decades… or centuries. In the meantime parents need to understand that proper rest oral posture matters for proper facial growth….period.